Medical Billing Coding - IS THE GRASS REALLY GREENER ON THE OTHER SIDE, cpt, codes
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Topic Originator: Jonathan Cholak
Post Date August 6, 2008 @ 11:41 AM

Jonathan Cholak
August 6, 2008 @ 11:41 AM Reply  |  Email Friend   |  |Print  |  Top

Hello Everyone,

My name is Jonathan Cholak and perhaps you could help me out.  I currently am doing my Master in Health Service Administration at UDM and am almost done.  I am about to start my internship at a big hospital and the salary will range from $50-70K, which is good money.  However, I have always been fond of medical billing and recently received my certificate from a local community college.

I do have some experience in the field, but the question or problem I find myself in is...can I make more money in Medical billing than taking the position at the hospital?  I have a big networking force in MI and am confident of getting accounts, but I fear that I will not make that much money.  In the past, I was in the process of buying a Medical billing firm that did 300K in anual revenue, but the owner was only taking home it really worth it to do all this hard work and barely take any money home at the end of the day?

If you do respond to this post, your comments are more than welcomed, but please throw out some actual numbers so that I could get a clearer picture


August 6, 2008 @ 3:58 PM Reply  |  Email Friend   |  |Print  |  Top

Take your $50-70K job!! And if you love medical billing/business ownership do it part-time! From there and if you think you can grow up and make more than what you make with your current degree, say bye bye.

August 10, 2008 @ 5:31 PM Reply  |  Email Friend   |  |Print  |  Top


Although you may manaage to pull down that much in net income working for yourself as an outsourced biller, you will still not make enough to give yourself the benefits you'll get at your future position.  Remember, things like health insurance, PTO, 401Ks, etc. can easily double employee costs - which means to equal your benefits as well as salary you'll have to be making approximately $100K-$150K per year -and possible more because you may not be eligible for all the discounts and tax breaks that are available to corporations offering employee benefit plans.  Again, it's possible, but the odds are stacked against you.

As far as working part-time as an independent biller - it's always possible, but only recommended to those that cannot afford to support themselves while buildin gup their business and must keept their "day job" until they're established.  Marketing, initial prospect contacts and set-up acitivities just cannot be perfomred very well "after hours".  Once you get the contract you hae issues with client and patient calls and insurers that don't have websites, IVR lines, and extended hours making it impossible to follow up on unpaid or improperly paid claims.  If you have to moonlight, then do it - but you cannot seriously think you can run a medical billing business after hours on a long-term basis.

August 11, 2008 @ 1:10 PM Reply  |  Email Friend   |  |Print  |  Top

Hi Jonathan,

We pay our billers more than $30,000 /yr.  Why would we take home the same thing?  Our payroll will probably be over half mill this year.  But is has taken us 4 years to get to this place.  Last year was the toughest but we stuck with it and things have turned the corner.  I just bought my wife a 300 Touring with 22 inch wheels and the Bentley Grill.  She looks good in it except you have to look hard through the tinted windows to see her, LOL.  

I say all of this, to say to you, if you have the vision, the drive, the determination to not fail, then yes, you can do better than 50-70 thou a year.  But be prepared for some lean years when you have zero taxes to pay, having to go without a vacation or buying the better cuts of beef, or having friends over without worrying if their presence will cause you electric bill to ggo up even a dollar of two.

You will need to be HIPAA compliant in your office, have a dedicated fax line, phone line, high speed internet, toll free number if you want clients from accross the country or even in the next LATA.  Havinfg a million dollars in "errors and omissions" is a good insurance to have.  If you want to have employees or contract workers, you will want a good contract for them.  When designing your contract for potential providers, you will want to set guidelines and boundaries on how you will process the work, receive the work, request further info to do the work, establish how you will receive the eobs, set up standards for ehical work practices by both parties, state clearly how you will end the working relationship if either party decises to end the contract, how many days you wil take to "run down" at the end of a contract, if you will do any AR as part of the contract, will the AR be a separate contract, how much will you will charge on collected fees, when you will end the month (such as the first five business days of the next month,) how to settle uncollectible charges, tracking cash paying customers, handling customer calls tto the billing company, plus several othe issues that will need to be covered in a contract, which should be called an agreement, such as Services Agreement.  For the sake of your providers, you might want to provide the Business Associate Agreement because most providers have no clue they should have one.  You will also want to have a conffidentiality agreement to be signed by both parties, even though you may not take a provider on.  This is for your protection and also helps relax a potential client.

You will want professionally prepared business cards, brochures, website, and probably a payment site to help patients make their statement payments online.

But don't let these few things get in the way.  As kathy said in a BC article "Go for The Gold."

Jonathan Cholak
August 11, 2008 @ 6:06 PM Reply  |  Email Friend   |  |Print  |  Top

Hi Dan,

This letter is from the bottom of my heart, but I first wanted to say thank you for your reply and encouragement.  I was losing hope in fully pursuing Medical Billing.  The reason being, I was in the process of buying a Medical Billing company and after reviewing all the numbers and such, the company was losing big time.  So, instead of taking over a company, I decided to start from the ground up.  From my many months of research and education of the industry, my drive was starting to die out.  Along the way I have built up very good relations with doctors.  I actually have an appointment scheduled for tomorrow with a plastic surgeon who is also a family friend.  I am still young and dont want to make a bad career move in life.  But, I feel that I will be successful in this field because I have a very big networking force.  I know people who own businesses that are nationally recognized, but before I make the big leap, I wanted to make sure.  Again Dan, thank you for the encourage, I was starting to get disappointed with BC Advantage cause I felt no one was giving me straight answers to my questions.  I am a upfront person who just wants the truth.  

PS: Would you mind if I asked for you personal email, I ask you to mentor me.  There is no ulterior motives, just want to deal with honest people who are willing to help out when time allows.

PSS: You picked out a nice car for your wife, those 300 C's are very nice

Jonathan Cholak

steve verno
August 13, 2008 @ 4:17 AM Reply  |  Email Friend   |  |Print  |  Top


There are good and bad companies out there. I saw a company only bring in $400,00 each month for the client.  The company was taken over by two good leaders who terminated these employees. We found unworked EOBs and unanswered correspondence in their desk drawers. These same employees spent most of their time at the smoking table outside and mostly what they did was complain.  

After terminating these employyes, the same company brought in an additional $200,00, using less employees.  The next month, the revenue increased to $800,000.  In a few more months, the revenue topped more than $1,000,000.  The key was getting rid of the complacent employee, hiring the eager employees and training them to do things the right way.  

With another practice, I recommended the office managr, son of the provider, terminate his billing company.  They werent bringing in alot of money and had a high AR on the books.  We brought the billing and coding in house and trained the two staff members. I oo on the AR Recovery myself and in 3 years of 3 hours on a saturday, got his AR cleaned up.  So dont become discouraged if you see a troubled company.  It may have potential and potential is what exists in our profession.  You can obtain the best company, but if you dont have the right employees with the winning attitude, the company will always fail.

Ive known Kathy Young for many years.  she is always eager and has a high positive attitude.  That is the mark of an excellent leader and who you want in this business.  Your goal is to go for the money. It is out there.

I started out in this business making minimum wage of $6.00 per hour.  In 4 years, I worked that up to $13 per hour and a month later was making $100 per hour.   Just FYI, I do not mentor.  I was asked that by a group of people from India. What they wanted from me was to redevelop their newly purchased billing compay by creting their policies and procedures. They also wanted me to train their staff,  The training would come ATER I recrouted the providers for thei business. After doing the base work, it was thanks and bye bye. No payment came forth for my work.  Basically it was try and sue us in court, we're not subject to your laws.  They still e-mail me now and then asking me to come back to help them.  I dont respond to their e-mails.  

BTW, to our Indian bothers and sisters: Congratulations on Indias's first Gold Medal in the Olympics!!!    In the words of the Love Guru -  Mariska Hargitay

Jonathan Cholak
August 13, 2008 @ 11:16 AM Reply  |  Email Friend   |  |Print  |  Top


First, I wanted to say thank you for responding to my emails, I track down many of your recommendations and take them to heart.  I love everything about Medical Billing because of the hours, type of work, freedom of the job, and the money.  The type of person I am is, I see something and then I go after it full force.  When I decided to pursue medical billing, I read books after book then enrolled into a local community college to get my certificate in Medical Billing and Coding.  I am a very determined person and self motivated who likes to look at life at a positive angle.  I get up everyday and praise God for what He has done for me and in my life.  Many doors have opened up since meeting my cousin who is a plastic surgeon; we started talking about the business.  He was very interested and has invited me to go to a golf outing with his fellow colleagues.  I definitely have the right connections, now I need to learn the legal work-contracts-behind the business. I know about 90% of the business, but would still like to hire someone with many years of experience.  

PS: Steve, if you know anyone in the Detroit area and has many years of experience&can you give me their contact info.  I have decided to give a portion or percentage of the account to that person who works for me&and we are talking about hospitals and urgent care centers&big venues, no little doctors office around the corner.  This offer goes out to everyone reading this reply&..

PSS: Steve, and to the rest who responded to my email&thanks, I started to doubt myself and this website, but you guys have proved me wrong

Jonathan Cholak
Cornerstone Medical Billing Services

steve verno
August 14, 2008 @ 7:09 AM Reply  |  Email Friend   |  |Print  |  Top

I found billers who are among the best are the ones who LOVE what they do. When I worked, I couldnt wait to get to work.  I would run aging reports to work my part of the AR, work the correspondence to overturn denials and look at uninsured accounts to find insurance information.  

This profession is highly challenging and its those challenges that make us great.  You havent experienced the feel of success when you see a denial overturned and paid.

Just before my stroke, I worked AR Recovery for a DME company.  Everyone there was enthusiasic and loved what they did.  It was a joy driving the 2 hours to get to work.  Everyone there loved doing their job.  

If you ever get the chance to be where Kathy Young is talking, you see the love for the profession in her face, her voice and in her attitude.  

Ive seen where an HMO denied a claim four times and the people working the account were ready to give up. I asked for it and on my first appeal, I too got a denial, actually three more denials.  I never gave up and in the end, got a check for $1,200.  I also got denials from  major insurance company constantly saying what they paid is all they will pay. Never giving up, I got them to pay a six figure settlement.  With another provider, I appealed their payments,  the insurance company put pressure on the provider to get me to stop.  The provider caved in and lost $500,000.  Now all he does is complain about this same insurance company.  If he takes off the cuffs, i could get him that money.  Medical Billers love what they do and they never give up.  Yes, I had a heart attack and surgery as well as a stroke, but I am never giving up.  Whatever iitials we put after our names, the ones we should use are INGU.

Sadly, I dont know anyone in Detroit.  

BTW, on a side note, I was contacted by a physician in New York.  She was convicted on insurance fraud.  Part of her probation is a requiremen to have a Billng Monitor for a 3 year period.  If someone out there has excellent billing skills that could be approved by the NY State Parole Offices, and wishes to help this doctor by becoming a biling monitor.  This would entail reviewing charts to ensure what is being billed is correct, and providing quarterly reports to the court.  I have no clue on what the pay would be or any other details.  This could be something done at home.  There would be no medicare or medicaid billing due to being sanctioned for 5 years.  Mostly all patient billing.  The provider is locoated in Queens.  So, if someone is interested in becoming a Billign Monitor, let me know.  I will forward your info to the provider.  But, again, you would have to be approved by the court based on your training and experience.  Thanks

Linda Walker
September 9, 2008 @ 7:26 AM Reply  |  Email Friend   |  |Print  |  Top

I started my medical billing company back in the early 90's and there was money to be made and I made it. My background was working with insurance companies and I plain got lucky in the fact that I never had to put much effort into marketing. In 2000 I gave up billing and found the grass was MUCH greener on the consulting end, not to mention the overhead costs were much lower! I have quite a few regular clients and I like the diversity of setting up new offices so I get the best of both worlds and I'm never bored. I know many others that started and ran billing companies and went into consulting and they will probably agree with me. In the early 90's I left my position at the insurance company making about 45K but I wasn't the bread winner of the family so it really did not hurt me to leave my position.
I don't reccomend starting out with consulting until after you hit the ground running, but certainly keep your options open and always think outside the box. Anyone can submit claims!!

Linda Walker
Practice Managers Resource & Networking Community

March 14, 2009 @ 12:12 AM Reply  |  Email Friend   |  |Print  |  Top

Johnathan I am from detroit I recently moved to texas I am currently taking classes for medical billing and coding and I just wanted to first off say congrats on having those wonderful connects that is always a huge plus. Anyway I totally agree with you when you thanked those two guys for giving you some advice and encouragement (honest advice) I am new to this site and I have been feeling the same way you have about some of the responses that are given on this site. They seem kind of shallow, a bit dishonest, and at times kind of negative which is the last thing I need to hear when trying to go into this field. But I totally agree with what Steve said you have to be serious about this if you want to make this your career and make some serious money and I plan on doing like you , staying focused and moving full speed ahead.

June 7, 2011 @ 9:10 PM Reply  |  Email Friend   |  |Print  |  Top

Steve, could you tell me more about working for DME? I am a student who will be interning for a DME company. I will be taking my exam after I put in my hours for the intern. However, it seems like I won't gain any coding experience. Most of my classmates are waiting in line for our instructor to put them at a Hospital internship. Which one would help me in the future? Any input would be much appreciated. Thanks!


January 18, 2012 @ 11:52 AM Reply  |  Email Friend   |  |Print  |  Top

I am a RHIT and really discouraged at this point, I thought moving around in my traveling jobs would give me the experience to work in my home area, not so.  It has been nothing but miserable for me.  I have three plus years experience and what I have learned has not helped me at all.  I am ready to change careers completely.  What am I doing wrong?

Dan Young
March 12, 2012 @ 2:50 PM Reply  |  Email Friend   |  |Print  |  Top

Hello Patti,

1.  Have you set clear and attainable goals?  Such as Creating S.M.A.R.T. Goals

2.  Do you have a written work plan to attain those goals?  Here is a good site to go to:
3.  Have you established a network of like-minded individuals for accountability?  Here is a good site:
4.  have you joined any trade groups, such as the AAPC local chapter?  Here is where you can find the local chapter:
5.  Are you on LinkedIn?  This is a huge business social network:
6.  Be positive and remind yourself that you are loved and you will succeed.

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